The goal of the Training Program in Inflammatory and Immunological Disease (T32 AI07217) at the Duke University Medical Center (DUMC) is to train outstanding individuals to pursue independent careers in research relevant to 1) the pathogenesis of rheumatologic and immunologic diseases in children and adults and 2) the translation of new knowledge on disease mechanisms into innovative approaches to diagnosis, treatment or prevention of disease. These individuals may hold the M.D., M.D./Ph.D. or Ph.D. degrees and will gain specialized training to work at the interface of clinical and basic research;to utilize state of the art molecular, genetic and genomic approaches to develop new immunomodulatory agents and understand their mechanisms of action;and to manage complex datasets to develop better predictors of disease prognosis and response to treatment. As such, these individuals will be uniquely suited to advancing the goal of personalized medicine in the treatment of immune-mediated diseases. Importantly, this program will address the critical need for investigators conducting innovative research in inflammatory and immunological diseases in patients of all ages. We propose, through the continuation of our ongoing training program, to train individuals who can meet the challenge of modern biomedicine and have unique skills to participate in investigative teams in the full spectrum of "bench to bedside" research, ranging from fundamental laboratory research to clinical and epidemiological studies. This program will be highly interdisciplinary and interactive, encompassing both adult and pediatric rheumatology. Importantly, this program will emphasize collaboration and team approaches. Dr. David Pisetsky, Professor of Medicine and Immunology at DUMC and Chief of Rheumatology at the Durham Veterans Administration Medical Center (VAMC), will serve as Director while Dr. Laura Schanberg, Professor of Pediatrics and Co-Chief of Pediatric Rheumatology, will serve as Co-Director. To promote its activities, the training program incorporates a core of investigators from the Divisions of Rheumatology in the Departments of Medicine and Pediatrics as well as a talented and diverse coterie of researchers in other clinical as well as basic science departments. This proposal builds on a long history of successful training programs in adult and pediatric rheumatology and immunology at the DUMC;the existing highly effective and productive collaboration between the divisions in both training and research;and strong institutional support from both clinical departments as well as the Department of Immunology. PUBLIC HEALTH RELEVANCE: The training program will promote the training of highly skilled investigators who are able to conduct independent research programs to translate laboratory advances into new approaches for diagnosis, treatment and prevention of inflammatory and immune mediated diseases in people of all ages. At present, there is a severe shortage of investigators to take advantage of research advances especially in the field of pediatric rheumatology. The training program will emphasize the full range of research skills including specialized training in clinical research.